Document Detail


Are steroids useful to treat cerebral venous thrombosis?
MedLine Citation:
PMID:  18063833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: No randomized controlled trial has evaluated the efficacy of steroids in acute cerebral venous thrombosis (CVT). We aimed to analyze the effect of steroids on the outcome of patients in the International Study on Cerebral Veins and Dural Sinus Thrombosis (ISCVT). METHODS: ISCVT is a prospective observational study that included 624 CVT patients. Death or dependence at 6 months was compared between cases (patients treated with steroids) and controls (patients not treated with steroids), using 3 designs: (1) Matched case-control study (each case matched with a control for prognostic factors); (2) Nonmatched case-control study of the ISCVT cohort; (3) Case-control study in different strata according to the number of poor prognostic variables in each patient. RESULTS: One hundred and fifty (24%) patients were treated with steroids. (1) In the matched case-control study, poor outcome was similar in the two groups of patients (26/146 versus 17/149, OR=1.7; 95% CI 0.9 to 3.3, P=0.119). (2) In the ISCVT cohort, no significant difference in poor outcomes was found whether patients were treated with steroids or not (26/146 versus 60/469, OR=1.5; 95% CI 0.9 to 2.4). Patients without parenchymal lesions treated with steroids had worse prognosis than those treated without steroids (8/45 versus 9/184, OR=4.2, 95% CI 1.6 to 11.6, P=0.008). (3) Treatment with steroids was not associated with a better outcome in any strata of patients according to the number of poor prognostic factors. CONCLUSIONS: Steroids in the acute phase of CVT were not useful and were detrimental in patients without parenchymal cerebral lesions. These results do not support the use of steroids in CVT (evidence level III).
Authors:
Patrícia Canhão; Ana Cortesão; Marta Cabral; José M Ferro; Jan Stam; Marie-Germaine Bousser; Fernando Barinagarrementeria;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-12-06
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-27     Completed Date:  2008-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Affiliation:
Department of Clinical Neurosciences and Mental Health, Hospital Santa Maria, 1649-035 Lisbon, Portugal. pcanhao@fm.ul.pt
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cerebral Veins / pathology
Female
Humans
International Cooperation
Intracranial Thrombosis / drug therapy*,  pathology
Male
Prognosis
Steroids / adverse effects*,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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